A Rare Case of Paraneoplastic Syndrome Presented with Severe Gastroparesis due to Ganglional Loss

Abstract

Paraneoplastic syndromes are rare initial manifestations of a neoplastic disorder that may precede the actual detection of an overt cancer. These syndromes can generally involve any organic system of the human body with gastroparesis being the commonest manifestation of the paraneoplastic involvement of the neuronal bodies of the gastrointestinal tract in cancer patients. Gastroparesis is the result of an autoimmune destruction of the nerve plexus of the stomach that causes nonspecific gastrointestinal symptoms such as intractable vomiting and abdominal discomfort that interfere with patients' quality of life and are often ascribed to psychological factors. Thus, if not suspected, it easily evades the diagnostic thought especially in those cases where the diagnostic work up has not detected any apparent cause. Consequently, it should always be considered in patients with diagnosed or suspected cancer who complain of unexplained gastrointestinal symptoms. In our report, so as to increase the clinical awareness of this rare clinical entity, we present the case of a 70-year-old Caucasian female who presented in our hospital with severe gastroparesis that was later proven to be associated with an overt small cell lung cancer (SCLC) and we discuss the existing knowledge of the pathophysiology, diagnosis, and management of this disorder.

Self-expandable metal stent of esophagogastric junction versus pyloric area obstruction in advanced gastric cancer patients

“…[ 19 ] Considering the lack of statistical significance, the lesion characteristics had no influence on the procedure success rate of both groups. [ 20 ]…”

Chronic Feeding Intolerance: Management in Geriatric Palliative Care

“…FI may be acute and rapidly remitting or may last for long periods of time, hindering oral administration of medications and oral nutrition [1][2][3]. In association with cancer functional FI may appear as a paraneoplastic syndrome, at a distance from the tumor and elicited through humoral mediators [10]. Cancer involving the stomach or duodenum, yet not occlusive, may trigger a dysfunctional peristalsis that causes FI.…”

A Case of Extreme Gastroparesis due to an Occult Small Cell Cancer of the Lung

“…Histological examination of the resected stomach showed absence of ganglion cells with associated chronically inflamed nerve fibres suggestive of gastroparesis due to nerve injury [5]. …”

“…Its pathophysiology remains unclear. However, serological detection of anti-Hu autoantibodies suggests an autoimmune destruction of the euronal plexus of the stomach as the main mechanism for its development [ 5 ].…”

“…In one patient presenting with gastroparesis surgery was done and the stomach was removed in order to restore passage of liquids and food. Histological examination of the resected stomach showed absence of ganglion cells with associated chronically inflamed nerve fibres suggestive of gastroparesis due to nerve injury [ 5 ].…”